Mental Illness vs Substance Abuse

Before I write more on Rich’s sessions I’d like to go into Mental Illness vs Substance Abuse. This is a real issue and a dangerous one. Mistakes are made frequently when confronted with the unknown. Symptoms are quite similar so hopefully this will help guide you if you need it one day.

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When I first struggled with depression I was a 39-year old single father. My moods became erratic and people around me were trying to figure out what was going on. One night where I was particularly down, a friend called because she and others believed my issues were drug related. With my situation this wasn’t the case, but she wanted to come over with a drug detection kit. This was obviously frustrating to hear and hard to deal with. Embarrassing as well.

Believe it or not my friend was trying to help. Anytime someone is worried about you it’s a good thing. In my state I didn’t see the good. I was furious to have to answer to such allegations. I was furious that my responses weren’t being heard. As it turns out she wasn’t the only one who felt drugs was a problem. My sister believed it as well, but she was also the only one protecting me. Like I mentioned earlier it’s a good thing if people are concerned, but the bad news, nobody else cared about what I was saying. Common theme here.

Unknowingly to them, the drug conversations were increasing my desire to no longer be alive.

So why bring this experience up? I’m hoping to bring calm to a storm that only ends up hurting relationships. I would encourage family and friends of someone spiraling out of control to hold off from assuming or judging. Your loved one or friend simply wants to be heard. If you suspect substance abuse ask him/her to spend a day with you. Addicts use. Their behavior and actions will tell you. Still, no judgement or assumptions.

What to look for with substance abuse:

  1. During your full day with him/her do they excuse themselves to go to the bathroom or excuse themselves a lot? Multiple times in an hour?
  2. After returning from the bathroom or garage, etc., do you see a spike in their mood? This may occur often after excusing themselves. They leave looking down and sad, return with energy and being up. Again, many times during a day together.
  3. Don’t go off of irritability, being too hyper or odd movements (i.e. scratching their arm often, tapping fingers). These symptoms alone may signal mental illness.
  4. Try to explain how you feel about him/her and express concern. Not about anything specific like people said to me. Tell them you’ve noticed some changes that concerns you.
  5. Ask what you can do to help them. I was yelled at by 4 people that I recall. Yelling with judgement is an awful mix. People weren’t asking me how to help, they accused then talked down to me.

Drug addiction isn’t an automatic sign that a person is bad. They are in a bad situation that those who care can assist with. I knew immediately who really cared.

Please reserve judgement until you have heard and learned all he/she has been through and been diagnosed with. Rule of thumb, do not assume.

I asked a drug and alcohol counselor to go through my past with doctors, hospitals, the law and pharmacies. Going back 10-years I was cleared. I didn’t say anything to my accusers. That was for me in case I need it for later.

Chapter Four

PTSD

PTSD

Post-traumatic stress disorder (PTSD) is a mental health condition that’s triggered by a terrifying event — either experiencing it or witnessing it. Symptoms may include flashbacks, nightmares and severe anxiety, as well as uncontrollable thoughts about the event.

Many people who go through traumatic events have difficulty adjusting and coping for a while, but they don’t have PTSD — with time and good self-care, they usually get better. But if the symptoms get worse or last for months or even years and interfere with your functioning, you may have PTSD. (Mayo Clinic)

PTSD is often misdiagnosed by doctors and its symptoms are often ignored by patients. Other patients, like Rich, don’t believe it can affect them because it’s linked many times to soldiers. Rich’s diagnosis was missed for three years. During that time he was treated as having a personality disorder. Much different.

Rich has never fully divulged the cause, but the years 2005 – 2011 play a significant role. Even to this date he has never talked about his marriage ending. We do know in 2011Rich’s kids were the subject of a custody battle. The people trying to gain custody were from Arizona and related to his ex wife. They made several threats, most being scare tactics. Unfortunately it wasn’t long before Rich’s kids were made aware of the attempt to move them to Arizona. His youngest daughter began having nightmares of being kidnapped, while the boys were stressed each day wondering if they would lose their dad. At one point they tried to convince his 16-year old that Rich was unfit to be a father.

Rich finally broke down attempting suicide for the first time. The reason was simple. If the kids were lost he would’ve been left without his heart’s protection. The only four people on earth who had been with him through all that had occurred. Most friends and family were not supportive because they believed the Arizona people who claimed Rich was a drug addict. Even the person he was closest to while growing up never questioned if the accusations were true. It was becoming too much.

Due to his illness and suicide attempt, Rich was hospitalized for the first time……(chapter continues in book)

Chapter Three

The first two chapters have shown some of the frustrations doctors face when trying to treat patients. Some topics are easy for Rich to delve into, while others are off the table. Rich also gets tired and irritable much more quickly during certain parts of the session. He’s really quite unpredictable.

Still, these conversations are crucial during the process of managing depression and/or PTSD.

The exact diagnosis to date for Rich is PTSD w/situational depression. In other words, things in his past were so tramatic that dreams are even affected. Another issue created due to his delay in treatment is the presentation of Partial Seizures. It’s a frontal lobe, focal seizure, with altered sense of hearing, smelling, tasting, seeing, and tactile perception (sensory illusions), or feeling as though the environment is not real (derealization) or dissociation from the environment or self (depersonalization).

In the case of our patient, Rich, his experience begins with an aura, or odd smell. Soon after he is finding himself in a different place with people he doesn’t know. The activity seems real, but Rich is aware it is not. When Rich is in this state, the people who see him in the real existence think he’s in deep thought, staring straight ahead. The activity can last 3 – 5 minutes and after he may feel no real problems. Other times he has vomited and has been exhausted. Time is probably the factor in how he feels after the conclusion.

Currently Rich is taking a medication that has stopped the seizures all together. Additionally the nightmares have ceased. A major advantage with this medication is how dose increases are not necessary. One pill, every evening.

This information is important for the topic of chapter four, which will be the cause.  Finally.

So there is no confusion, the title character is indeed me. This was mentioned prior but a reminder can’t hurt. – Thanks.

Chapter Two

After a few days in Rich was getting used to talking. It was tough at first because everyone wanted to hear stories. He wasn’t always willing to share, but he tried. The place he spent time in was very casual and not how the TV shows or movies portray them. It was comfortable and the food was outstanding. But it wasn’t home which made treatment difficult to continue as inpatient.

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“It’s been a week, Rich,” Dr. Miken said. “How are you holding up?”

“I miss my kids,” Rich responded.

“How are the kids doing with you being gone?”

“Depends on the kid. My oldest seems good but my youngest cries each night. I came here because I decided to confront my recent struggles. That’s very difficult when my little girl is sad. We’ve never been apart overnight in her nine years on earth. She’s really hurting. She needs me.”

Dr. Miken paused for a bit as he collected his thoughts. Clearly this was a distraction that was negatively impacting the treatment plan.

“Rich, I spoke to one of your friends who was concerned about this becoming an obstacle. You speak often about your perceived shortcomings but you won’t acknowledge how well you’ve done as a dad. Why is that?”

“A parent shouldn’t be rewarded for loving their kids. My kids trust me and know I’d never hurt them intentionally. Every child should be confident in that.”

At this point Rich became angry. To be angry, as his friends would tell you, is quite rare. He continued:

“The kids mom apparently decided that wasn’t necessary. Do you know she dropped the kids off at my friend’s house, in the cold, saying, ‘goodbye, be back soon’ when she knew she was leaving them for good? My nine year old son ran to her, crying, begging her not to leave him. Her response? ‘I’ll be back, promise’!” That was two years ago, doc. For 8 straight nights I rotated holding my six year old and nine year old as they cried themselves to sleep. My job is to protect them and in that moment I failed! So no, I’m not going to acknowledge failure! Their pain was outside my abilities to control! Yeah, what a great dad.”

For the next ten minutes Dr. Miken helped Rich to settle his anger. Rich was so angry he started shaking. He has only shown such strong emotions when the conversation turns to the kid’s struggles. After some time Rich was able to continue.

Chapter One

The following chapters are from actual events. All interviews are accurate, although names of the individuals and medical centers aside from Rich have been changed. As Rich, I did my very best to recall all dialogue. This proved quite difficult, but the tone and subject matters are 100% accurate. Enjoy!

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CHAPTER ONE

The following conversation took place shortly after the patient, Rich, was admitted to the Behavioral Health Unit of a local hospital in Washington State. Dr. Miken, M.D. was the lead doctor for Rich’s case.

“……..Rich, you need to learn the importance of forgiveness in all its forms”, said Dr. Miken. “You’ve been hurt by many people you trusted for years. They know they hurt you. Yet, with that knowledge only a few apologized. I just wonder if knowing you deserve apologies can be enough for you.”

The doctor continued, as he tried to help Rich change his negative view of a traumatic event. Rich was barely engaged, slumping low in his chair, eyes down.

“Look, Rich. You didn’t lose the kids. You gained friends while strengthening established friendships. You can finally breathe again. Why won’t you?”

“Why?” Rich asked with an annoyed tone. “People who should’ve been thinking about what’s best for my kids put them through hell!” he exclaimed. “They decided that hating me was more important than loving the kids! Grandparents, aunts, uncles, friends. All of them wanted to appear to be great, while hurting my kids along the way! Unforgivable!”

Rich’s position regarding the custody questions raised by relatives has never changed. Soon after the kid’s mom left them, he became a single parent. Her family decided it was “best” if they raised the kids, removing any influence Rich may have with them. Even though many loving, wonderful people stepped in to help Rich keep full custody, the damage caused by the threat took a toll. The conversation continued:

“Dr. Miken, I’m tired,” Rich explained in a more reserved tone. “I rarely sleep anymore and when I do the nightmares are just awful.”

“Explain for me a typical nightmare,” Dr. Miken requested.

“Well,” Rich explained. “Usually the setting is an unfamiliar place sitting atop a cliff. Inevitably a series of events take place, ending with the kids falling off. The end never changes, but up to the ending is always different.”

Dr. Miken noticed a change in Rich’s facial expressions and body language as he described the dreams. Clearly these dreams Rich spoke of had become disruptive even while he was awake. Rich’s eyes opened wider, his pupils became dilated and he was rubbing his hands on his legs. Yet, even with his growing anxiety, Rich wanted to continue:

 “Let’s focus for a moment on the these dreams, from the beginning to just before the kids fall off the cliff, Rich,” said Dr. Miken. “Are you always outdoors when you’re with the kids?”

“Yes, always,” Rich answered.

“Is there weather in these dreams?”

“Yes. In fact it’s always very cloudy and dreary.”

“Are you usually nervous or scared from the beginning?”

“Terrified!” Rich quickly answered sitting up higher in the chair.

“Why terrified?”

Again answering quickly, “Because I’m constantly anxious about the cliff and keeping my kids safe.” His tone softens, “What’s odd is that I know I can’t stop it.”

“Rich, would you say you lose control of everything in this setting?”

“All control,” Rich replied.

“Would you say that feeling is similar to the feeling you had during the situation you experienced with the kids?”

Rich paused, head dropping bit, a single tear rolling down his cheek.

“Why did they try to hurt us?” he asked.

“Not important anymore.” Dr, Miken answered. “Understanding that will help eliminate those nightmares and allow for peace of mind.”

As this session ended, an emotionally drained Rich returned to his room to rest. Although he didn’t understand at the time, this exchange would prove invaluable in the future.

Witness To Tragic Circumstances

Thank you Pioneer Media
Thank you Pioneer Media

In this 5th and final installment of my experiences, I’d like to share a story of a family I became familiar with at one of the shelters. I never understood the number of families living life in and out of shelters. This is one family’s story:

It was a day that was uneventful and quiet. The temperature dropped to 13°F the night before, opening space at the shelter. The place was packed with people of various ethnicities, both men and women. It wasn’t long before I saw some children walking around. Many mothers carrying babies and toddlers.

With everything I witnessed to that point, nothing affected me more than the site of these homeless children.

As I sat trying to make sense of what I was seeing, a young family sat across from me. The dad, Jason, was quick to introduce himself and start a conversation. He looked worn down by the situation his family was in. His eyes were red, eyelids drooping. There was a noticible stench coming from his worn out clothes. He would later explain it had been many days since he had a shower.

Before coming to the shelter he and his wife, with two kids, were living in their 1987 Mustang. The inside of the car smelled like a bag of dirty diapers. Thankfully the freezing wind took care of that relatively quick. Although I will admit I was regretting offering my help to clean it out. Jason seemed embarrassed while we were removing the trash. I tried to make him feel comfortable by telling him it wasn’t a big deal, but it didn’t work. As he put it, “I can’t believe cleaning my car is also cleaning my home”.

Due to the weather I was able to stay at the shelter, spending a lot of time with Jason and his family. His wife wasn’t a pleasant woman, as you can imagine, constantly yelling at Jason. She also found it difficult to be positive with the kids, but she found a way to hug them and express her love for them.

I mentioned earlier that they had two kids with them. The little girl was 3 and her big brother was 5. They were very sweet, never acted out, always smiling. That told me they hadn’t always lived in such a situation. It also speaks volumes as to the love they were shown, even in the worst of times.

The shelter had a rule that only the dad could stay there, while mom and the kids spent the night at a women’s shelter. Nights were a difficult time for everyone, but especially for those of us who were away from our kids. My situation was different because my kids were being cared for by amazing, loving families. They were always safe, warm and comfortable. Dads like Jason worried every night, wondering if everyone was comfortable and safe. There were several times during the night where he broke down crying. His pain was constant and without relief. So Jason decided to help himself.

Shelters have strict policies regarding alcohol and narcotics. If anyone wanted to leave they had to sign out. If a person was out for longer than a few hours they were asked to provide a urine sample and/or do a breathalyzer. If either failed, the individual was asked to leave. Sometimes the authorities were called in. One night Jason had been out for about five hours. I went outside to get some air and noticed Jason trying to park his car. He stopped, hit the steering wheel and yelled. I walked over and knew immediately he was under the influence of something or things. He didn’t even recognize me for about two minutes (he kept calling me Willie).

I was finally able to get the keys and safely park his car. His troubles, however, were far from over. There was no way he could pass a drug test of any kind. I thought of a plan that might work to get him in, but explaining to Jason what he needed to do proved to be tough. After some time he was ready. As we opened the door to get in, Jason covered his face with his hands pretending to cry. I walked him to a seat and approached the front desk. I explained I was checking Jason in and that he was an emotional mess. I was simply told to get him to bed and he was marked in. Was it stupid what he did? Yes. My reason for helping was less about Jason and more about his kids having a place to spend time with their dad.

Every time I saw Jason’s kids I was heartbroken. Children shouldn’t be in that environment, but it’s much better than the car. Many people wonder why CPS isn’t called for homeless children. In Jason’s case, as odd as it seems, those kids were not better off away from their parents. Obviously if abuse is present it changes everything. With Jason this wasn’t an issue, probably never would be.

There were many nights I cried myself to sleep because of how much I missed my kids, but I was never more emotional then the times I saw kids at the shelter. Not all kids were doing as well as Jason’s and there were times officers came to the shelter to take kids away. Most of the time it was based on anonymous tips about abuse towards the kids, or evidence of drug abuse. Either way the situation was tragic, both for the parents and kids, but mostly for those innocent children who found themselves powerless.

I’ve spent a lot of time writing about my personal trials during a difficult period. It’s only fair, it’s the right thing, to describe a world most readers will never live in. Take just a moment to look in on your kids sleeping in their beds, in their warm rooms. Try to envision how difficult a world of shelters and having cars as homes would be on kids their age.

Of everything I experienced and witnessed, seeing those kids without a home and possessions was the most devastating. Even now, during the quiet of night, I find myself crying about what I saw.

It will never leave me.

When Stress and Feelings Are Ignored

Thank you allmusic.com
Thank you allmusic.com

Each night without a place to sleep seemed like eternity. In the winter I had to keep moving, keep my blood circulating. This was quite painful at times because of the effect the below freezing temperatures had on my toes. Each step was like repeated jabs with needles. Still, without a warm alternative there wasn’t much else to do. This was my life now and in order to stay alive I needed to find ways to relieve the stress on my body.

One particular night stands out like no other during that winter. After walking several miles to see if there were any vacancies in the city’s shelters, my eyes became heavy. I needed somewhere to rest, possibly get a little sleep. I wouldn’t get a lot with it being 4:15am, but at least it would be something.

I was able to find a spot near Gonzaga University which was barely visible from the sidewalk. I layed a jacket on the frozen ground and used my duffle bag as a pillow. The bushes surrounding me did a great job blocking the chilling wind. With the combination of exhaustion and cold I was asleep soon after I layed down.

Suddenly, as if only a minute had passed, I awoke standing in a frosted-over field, cold and confused. I could hear the sound of voices that seemed far away. Every direction I turned showed a long stretch of field meeting the sky.  The voices were barely audible through the wind, but the louder they would get, the more frantic they would sound.

I began running in the direction it seemed the voices were coming from. The more I ran, however, the more they’d fade. I turned, hoping to follow the sounds in a different direction, but again they moved away. Just as I felt ready to give up searching, the wind ceased. The muffled voices became quite clear, very familiar.

Behind a large, weather damaged wood fence was the origin of these voices. Why this fence wasn’t visible earlier, I didn’t know, but I didn’t much care. I sprinted towards the fence, voices becoming louder and louder at each step. I finally reached the fence and in a quick moment of silence I heard a very clear yell for help. The cry was from my daughter, Avery.

With no visible door I decide to climb, but the ice and cold made scaling the wall impossible. I then made a tight fist, punching a hole through the fence. I began pulling boards apart, trying to make space for me to step through. It was then I heard Noah yell out for help. Then Kelsea. Then Krissy. Lastly Jensen. As I broke through the fence I noticed a cliff just ahead which was, without question, where the voices were coming from.

As I reached the cliff I looked over to see each of my kids barely holding on to rocks, bodies dangling hundreds of feet above a busy street below. Each of them were too far down to reach so I removed my coat to lower towards Avery. As it reached her she grabbed it with one hand, then slowly with the other. As I began to pull, I see out of the corner of my right eye a hand slip. I turned my head in time to see Jensen fall, screaming for me to save him. Then his voice and body disappeared.

I continued pulling when I heard another scream as Kelsea was unable to hold on. I didn’t have time to react as I was still pulling Avery to the top. Like a cruel joke, no matter how quickly I pulled, Avery would drop further away. Krissy then slipped, falling and screaming for me to reach for her, but I was helpless. Eventually, this time without a sound, Avery disappeared. All the screams had turned to silence. They were all gone.

After some time staring over the edge, I turned to find my way back from the horror I had witnessed. Just then a truck started heading for me, it’s engine louder and louder the closer it got. The large field I once stood on had turned into a narrow alley, a tall brick wall opposite the oncoming truck. There was nowhere for me to run, so I faced the truck, embraced for impact and…….

It was over. I awoke to the sound of a garbage truck at 5:30am. My heart was racing and I was a little confused about where I was. Once fully awake, I knew nothing was wrong with the kids. Still, even with that knowledge, I was affected deeply. It was the most realistic dream I ever had. Only an hour had passed since I fell asleep, but the intensity of my dream had me feeling as though I was gone much longer

All the hopelessness and helplessness I had been feeling each day but refused to face, came out in one terrifying dream. Without the security of having a destination each evening, those feelings increased dramatically.

It took time but eventually I came to terms with this new reality. With the help of a counselor I was finally working through the fears and issues. I was soon diagnosed with PTSD, allowing for the proper therapy to take place.

Speaking up and asking for help doesn’t mean you’re a quitter. I means you’re ready to accept help. It’s courageous and selfless.

RTR